A re-examination of ERISA civil procedure

Although lawsuits challenging employee benefit denials under the Employee Retirement Income Security Act (ERISA) are brought as “civil actions” in accordance with the United States Code, the manner in which such cases are adjudicated deviates from the norm according to a recent article authored by Mark DeBofsky, “A Critical Appraisal of the Current State of […]

The list bill – inadvertently creating an ERISA plan?

A recent ruling from a federal court in Alabama – Rosen v. Provident Life and Accident Insur. Co., 2015 WL 260839 (N.D.Ala. January 21, 2015) addressed a controversial issue involving ERISA preemption. Typically, ERISA is implicated only where an employer sponsors a retirement plan or offers group coverage to its employees for disability, life, or […]

Job versus occupation

In evaluating occupational disability claims, insurers distinguish between the insured’s job and their occupation.  If an employee cannot perform their job, they may still be denied disability insurance benefits if they remain capable of performing their occupation as it is generally performed in the national economy.  Polnicky v. Liberty Life Assur.Co. of Boston, 2014 WL […]

How long may claim appeals be tolled?

A recent ruling from a federal court in Ohio discusses the interplay between the “deemed exhausted” provision of the ERISA claim regulations – 29 C.F.R. Sec. 2560.503-1(l) – and claim administrators’ requests to “toll” the clock on when claim appeals have to be decided.  In Gay v. National Rural Electric Cooperative Association Group Benefits Program, 2014 […]